JEREMIAH'S INN INC. NPI 1679019731

NPI Information

JEREMIAH'S INN INC. is a substance abuse rehabilitation facility in Worcester, MA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. JEREMIAH'S INN INC. NPI is 1679019731. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Jeremiah's Hospice.

The provider's business location address is:

1059 MAIN ST
WORCESTER, MA
ZIP 01603-421
Phone: (508) 755-6403
Fax: (508) 793-9568

The provider's authorized official is Melissa Ann Waddell .
The authorized official title is Communications Coordinator and has the following contact phone number (508) 755-6403.

The CLIA number assigned to this NPI record is 22D2218262 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/13/2017 and was last updated on 1/13/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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